Epidemiologic and Clinical Characteristics of Monkeypox Cases — United States, May 17–July 22, 2022
Authors: David Philpott, Christine M. Hughes, Karen A. Alroy, Janna L. Kerins, Jessica Pavlick, Lenore Asbel, Addie Crawley, Alexandra P. Newman, Hillary Spencer, Amanda Feldpausch, Kelly Cogswell, Kenneth R. Davis, Jinlene Chen, Tiffany Henderson, Katherine Murphy, Meghan Barnes, Brandi Hopkins, Mary-Margaret A. Fill, Anil T. Mangla, Dana Perella, Arti Barnes, Scott Hughes, Jayne Griffith, Abby L. Berns, Lauren Milroy, Haley Blake, Maria M. Sievers, Melissa Marzan-Rodriguez, Marco Tori, Stephanie R. Black, Erik Kopping, Irene Ruberto, Angela Maxted, Anuj Sharma, Kara Tarter, Sydney A. Jones, Brooklyn White, Ryan Chatelain, Mia Russo, Sarah Gillani, Ethan Bornstein, Stephen L. White, Shannon A. Johnson, Emma Ortega, Lori Saathoff-Huber, Anam Syed, Aprielle Wills, Bridget J. Anderson, Alexandra M. Oster, Athalia Christie, Jennifer McQuiston, Andrea M. McCollum, Agam K. Rao, María E. Negrón, Isabel Griffin, Mohammed Khan, Yasmin Ogale, Emily Sims, R. Ryan Lash, Jeanette J. Rainey, Kelly Charniga, Michelle A. Waltenburg, Patrick Dawson, Laura A.S. Quilter, Julie Rushmore, Mark R. Stenger, Rachel E. Kachur, Florence Whitehill, Kelly A. Jackson, Jim Collins, Kimberly Signs, Gillian Richardson, Julie Hand, Emily Spence-Davizon, Brandi Steidley, Matthew Osborne, Susan Soliva, Sabrina Cook, Leslie Ayuk-Takor, Christina Willut, Alexandria Snively, Nicholas Lehnertz, Daniela N. Quilliam, Miranda Durham, Iris R. Cardona-Gerena, Linda J. Bell, Environmental Control, Marina Kuljanin, Suzanne Gibbons-Burgener, Ryan Westergaard, Lynn E. Sosa, Monica Beddo, Matthew Donahue, Samir Koirala, Courtney Dewart, Jade Murray-Thompson, Lilian Peake, Michelle L. Holshue, Atul Kothari, Jamie Ahlers, Lauren Usagawa, Megan Cahill, Erin Ricketts, Mike Mannell, Farah S. Ahmed, Bethany Hodge, Brenton Nesemeier, Katherine Guinther, Madhu Anand, Jennifer L. White, Joel A. Ackelsberg, Ellen H. Lee, Devin Raman, Carmen Brown, Nicole Burton, Sarakay Johnson
Journal: MMWR Morbidity and Mortality Weekly Report (2022)

Monkeypox, a zoonotic infection caused by an orthopoxvirus, is endemic in parts of Africa. On August 4, 2022, the U.S. Department of Health and Human Services declared the U.S. monkeypox outbreak, which began on May 17, to be a public health emergency (1,2). After detection of the first U.S. monkeypox case), CDC and health departments implemented enhanced monkeypox case detection and reporting. Among 2,891 cases reported in the United States through July 22 by 43 states, Puerto Rico, and the District of Columbia (DC), CDC received case report forms for 1,195 (41%) cases by July 27. Among these, 99% of cases were among men; among men with available information, 94% reported male-to-male sexual or close intimate contact during the 3 weeks before symptom onset. Among the 88% of cases with available data, 41% were among non-Hispanic White (White) persons, 28% among Hispanic or Latino (Hispanic) persons, and 26% among non-Hispanic Black or African American (Black) persons. Forty-two percent of persons with monkeypox with available data did not report the typical prodrome as their first symptom, and 46% reported one or more genital lesions during their illness; 41% had HIV infection. Data suggest that widespread community transmission of monkeypox has disproportionately affected gay, bisexual, and other men who have sex with men and racial and ethnic minority groups. Compared with historical reports of monkeypox in areas with endemic disease, currently reported outbreak-associated cases are less likely to have a prodrome and more likely to have genital involvement. CDC and other federal, state, and local agencies have implemented response efforts to expand testing, treatment, and vaccination. Public health efforts should prioritize gay, bisexual, and other men who have sex with men, who are currently disproportionately affected, for prevention and testing, while addressing equity, minimizing stigma, and maintaining vigilance for transmission in other populations. Clinicians should test patients with rash consistent with monkeypox,† regardless of whether the rash is disseminated or was preceded by prodrome. Likewise, although most cases to date have occurred among gay, bisexual, and other men who have sex with men, any patient with rash consistent with monkeypox should be considered for testing. CDC is continually evaluating new evidence and tailoring response strategies as information on changing case demographics, clinical characteristics, transmission, and vaccine effectiveness become available.§.